On scienceblogs, Mike the Mad Biologist has a post up where he argues that certain types of beliefs inevitably lead to bullying and stigma, even if the people originally promoting the beliefs adopt a hate-the-sin-love-the-sinner attitude and are horrified that the stigma and bullying are occurring. (Let’s assume, for argument’s sake, that they are sincere in being horrified–and in fact, I have no doubt that at least some of them are sincere, although I also have no doubt that at least some of them don’t care or are even secretly happy.)

I’m sure that the writer does truly believe that gay marriage is wrong. It’s probably a strongly held belief, perhaps even fervently so.

And I don’t fucking care.

Because the consequences of this belief are that children are killing themselves. Fervency is as much as a hallmark of the decent as it is the insane.

But for some reason it has become fashionable to disassociate the consequences of beliefs (religious or otherwise) from their consequences, and, thus, they become unassailable. I believe them, therefore, they are legitimate. While this marks me as one of the remaining few humanists (albeit a religious one), ultimately beliefs have to be judged by their results.

Any belief, religious or not, that leads to a climate where children are more likely to kill themselves is one not worth having.

In this particular post, he’s talking about gay kids, but to me it immediately suggested parallels with fat kids, who are more likely to be bullied than kids who aren’t fat. (This site also documents some of the bullying that fat kids experience.) Kids who think they’re fat are also more likely to kill themselves. It’s easy enough to argue that a belief is harmful when you’ve already decided it’s not true–and I’m guessing that Mike doesn’t think that there’s anything immoral about being gay or choosing same-sex partners rather than opposite-sex ones. But what about harmful and stigmatizing beliefs that you believe are true–that are widely believed to be true even in progressive circles? And in the case of fat kids, what particular belief about fat is causing stigma?

I think that the beliefs lying at the root of fat stigma is that weight is primarily a matter of personal responsibility, anyone can be skinny, and all it takes is hard work for a little while, and then sensible habits like “turning down that third piece of pie”. For most people, it’s not that simple. Twin study estimates put BMI heritability at 70-80% (within the same society), and maintaining significant weight loss is usually a part-time job at best. If maintaining weight loss was easy, we wouldn’t see ~95% of dieters regain at least as much weight as they lost within five years.

If people believe that avoiding fat is a matter of not-that-hard work and moderate self-control, then stereotypes of fat people as lazy and lacking in self-control are not the root cause of the stigma–they are a natural consequence of these beliefs about what makes someone fat or skinny. Furthermore, if people believe that the main reason that they are not fat while other people are is their own hard work, believing that they have better character than fat people is a natural consequence. (If heritability estimates for BMI are correct, then obviously this belief is false; even if a given fat person can become permanently thin with enough work, odds are that the thin person is thin because of their genes and not because of their hard work. I’m not the first person to say that this is a classic case of being born on third and thinking you hit a triple.)

I’m skeptical of whether many of the health effects attributed directly to weight are really from the weight itself–but suppose you aren’t at all skeptical about that, yet you are concerned about fat stigma–and you’re ALSO concerned about the obesity epidemic and the health effects of being fat: what do you do? Perhaps the best thing to do would be to focus on behavior rather than on weight. Exercise and healthy food are associated with good health independently of weight. Lack of healthy food and lack of exercise are independently associated with poor health outcomes. Exercise can mitigate many of the health effects associated with high BMI and metabolic syndrome (e.g. insulin resistance). Focusing on healthy behavior like eating enough fruits and vegetables, drinking less soda, and getting enough exercise primarily as a means to weight loss means that slender people often think they don’t need to do those things; they’re dead wrong. Exercise has a stronger effect on health than weight; if we’re really concerned about health and not about how icky fat people are, why aren’t we focusing more on behavior than on obesity? And if you still think that remaining thin is mostly a matter of eating junk food in moderation and getting a decent amount of exercise, what exactly do we have to lose with this approach?

Stigma has its own indirect negative health consequences (besides the more direct consequence of suicide), which I hope to write about in another post soon. But right now I want to focus on this: encouraging stigma is morally wrong. Some beliefs predictably and almost inevitably lead to stigma. One of those beliefs is that everyone can and should lose weight. I do not share this belief, but even if you do: Given these facts, is it ethical to promote weight loss?

(Of course, some people would say yes, and even go further and argue that we should deliberately create more stigma in order to motivate people to lose weight. I think that this is unethical. It also doesn’t work, according to obesity researcher Rebecca Puhl: “We frequently encounter the argument that stigmatization may somehow motivate people to lose weight. But a large number of people in our study reported that they are less likely to diet and more likely to turn to food as a coping strategy when they encounter weight stigma.” Of course, it’s pretty obvious that it isn’t working, given the amount of stigma out there and the number of people who are still fat.)